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Genetic and Rare Diseases Information Center (GARD)

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Klumpke paralysis

Other Names for this Disease
  • Dejerine-Klumpke palsy
  • Klumpke's palsy
  • Lower brachial plexus palsy
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Your Question

What is the chance for children with Klumpke paralysis to recover arm and hand strength and mobility? How might Klumpke paralysis be treated? Will surgery benefit my child?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is Klumpke paralysis?

Klumpke paralysis is a type of brachial palsy in newborns. Signs and symptoms include weakness and loss of movement of the arm and hand.  Some babies experience drooping of the eyelid on the opposite side of the face as well.[1][2] This symptom may also be referred to as Horner syndrome.[2]

Klumpke paralysis is caused by an injury to the nerves of the brachial plexus which may result from a difficult delivery. This injury can cause a stretching (neuropraxia,), tearing (called “avulsion” when the tear is at the spine, and “rupture” when it is not), or scarring (neuroma) of the brachial plexus nerves. Most infants with Klumpke paralysis have the more mild form of injury (neuropraxia) and often recover within 6 months.[1][3]

Last updated: 2/25/2010

What is the typical prognosis (chance of recovery) for children with Klumpke paralysis?

The prognosis of infants and children Klumpke paralysis will depend on the severity of the injury, the time of onset, and initial (early) rate of improvement. For torn nerves (avulsion and rupture injuries), there is no potential for recovery unless surgical reconnection is made in a timely manner.[3]  Most individuals with neuropraxia injuries recover spontaneously with a 90-100% return of function.[3]  It is estimated that up to 88% of infants recover by 4 months, and 92% by 12 months.[2]
Last updated: 2/25/2010

How might Klumpke paralysis be treated?

The  affected arm may be immobilized across the body for 7 to 10 days.[3] For mild cases gentle massage of the arm and range-of-motion exercises may be recommended.[1] For torn nerves (avulsion and rupture injuries), symptoms may improve with surgery.[3]   

Most infants recover from neuropraxia within 4 months. Parents or guardians of infants that show no evidence of spontaneous recovery at 4 months,[2] may be counseled regarding additional treatment options. These treatment options may include:[1]

  • Surgery on the nerves (e.g., nerve grafts and neuroma excision)
  • Tendon transfers to help the muscles that are affected by nerve damage work better
Last updated: 2/25/2010

If a child with Klumpke paralysis shows no evidence of spontaneous recovery at 4 months, how might surgery improve symptoms?

Only a physician who is familiar with your child's medical history, including the extent and severity of the brachial plexus nerve injury, will be able to counsel you regarding the benefits of surgery. We recommend that you speak with your child's specialist to learn more. In the meantime, you may find the following free full text review article to be helpful. It details information regarding prognosis, surgical options, and outcomes. To view the full text article, click on the article's title below. In the next window, select the purple button on the right hand side.

Ruchelsman DE, Pettrone S, Price AE, Grossman J. Brachial Plexus Birth Palsy: An overview of early treatment options. Bulletin of the NYU Hospital for Joint Diseases. 2009;67(1):83-9.
Last updated: 2/25/2010